Comparative risk of death from induced abortion at less than or equal to 12 weeks' gestation performed with local versus general anesthesia

Abstract

Although complications of anesthesia are now the leading cause of death from abortion at less than or equal to 12 weeks' gestation, the comparative risk of death from abortions performed with local versus general anesthesia is unknown. To estimate this risk for both anesthesia-related and nonanesthesia-related legal abortion deaths at less than or equal to 12 weeks' gestation, we used 1972-1977 data from the Center for Disease Control and the Alan Guttmacher Institute. When adjusted for preexisting disease and concurrent sterilization, the death-to-case rate for abortions at less than or equal to 12 weeks' gestation associated with general anesthesia was 0.37/100,000 abortions, and the rate with local anesthesia was 0.15/100,000. For nonanesthesia-related deaths, the comparable adjusted rates were 0.49 and 0.28, respectively. Use of general anesthesia is associated with a twofold to fourfold increased risk of death from abortion at less than or equal to 12 weeks' gestation.